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Biomedical subjects

T P Hackett

Publications and source records attributed to T P Hackett.

At least 19 recordsLinked to original sources
PubMed1987

Alan Gregg and the rise of general hospital psychiatry.

The authors review the forces that encouraged the entry of psychiatry into the general hospital in the 1930s. Those forces, which included concern about increasing health care costs, pressure to reform medical and psychiatric education, and the growth of dynamic psychiatry and psychosomatic medicine, are described. The activities of Alan Gregg, Director of the Medical Sciences Division of the Rockefeller Foundation during that era are highlighted. Gregg encouraged research in neurobiologic correlates of psychiatric illness and funded psychiatric units in eight general hospitals in the United States. The authors suggest that the development of general hospital psychiatry was strongly influenced by Alan Gregg and his support for a medical model of psychiatric illness. In addition to other forces that spurred the growth of general hospital psychiatry, the authors suggest that Gregg's influence significantly aided psychiatry's entrance into the general hospital.

Education, Medical↗
PubMed1985

Components of type A, hostility, and anger-in: further relationships to angiographic findings.

In a previous study of patients undergoing angiography at Duke University Medical Center, we reported that of all components of the Type A behavior pattern (TABP), only Potential for Hostility and Anger-In were significantly associated with extent of coronary artery disease (CAD). The present study was undertaken to replicate these findings using a different patient population. Tape-recorded structured interviews from 125 angiography patients at Massachusetts General Hospital were blind scored using the component scoring system employed in the Duke study. The results confirmed our previous findings. Global TABP was completely unrelated to extent of CAD, while Potential for Hostility and Anger-In were significant independent predictors of disease severity. These findings argue for a reconceptualization of the manner in which the TABP is defined and assessed.

Adult↗
PubMed1982

The association of clinical, psychosocial, and angiographic variables with work status in patients with coronary artery disease.

The bearing of clinical history, epidemiological risk factors, psychosocial factors, angiographic findings, and treatment characteristics was studied in relationship to the work status of 182 men who underwent coronary angiography because of presumptive coronary artery disease. Follow-up at one year found 42% of the cohort persistently unemployed or working at a lower level, 40% at the same job, and 19% at a more demanding job. Multiple regression analysis was used to derive the most important variables predictive of work status. Neither number of vessels diseased nor Coronary Artery Bypass Graft surgery entered the multiple regression analysis. Instead, the most important variables, listed in decreasing order of importance, are: age, subsequent cardiac morbid events, past myocardial infarction, and mood during the follow-up year. Together, they account for 24% of the variance in work status outcome (p less than 0.001).

Angina Pectoris↗
PubMed1982

Effect of denial on cardiac health and psychological assessment.

To determine how denial of illness affects the relationship between self-reported psychological state and cardiac status, the authors studied 204 men with heart disease. Differing degrees of denial masked the relationship between multiple-vessel coronary disease and tension, depression, or fatigue. At 1-year follow-up, denial confused the relationship between fatigue and cardiac state. Denial may augment or diminish risk; patients with high denial who did not complain of depression or tension had a higher risk for coronary disease, and patients with low denial who complained of fatigue had more morbidity at follow-up. Because of its variable effects on illness and its role in confusing the relationship between psychological state and disease, denial must be evaluated carefully.

Anger↗
PubMed1981

Predicting cardiac morbidity based on risk factors and coronary angiographic findings.

A cohort of 189 men was followed up for 1 year after performance of coronary angiography and determination of risk factors to ascertain which risk factors or clinical and laboratory findings could aid in predicting the patients who would have a substantial cardiac morbid event. Data on clinical signs and symptoms, psychosocial assessments, angiographic findings and presence of standard risk factors for coronary artery disease were collected in each case. Twenty-five percent of the men experienced a substantial cardiac morbid event (hospitalization, myocardial infarction, resuscitation or death). With or without inclusion of the patients who underwent surgery, discriminant analysis equations were successful in predicting morbidity on the basis of risk factor data. For the whole sample such analysis was significant at p < 0.00005 and accurately predicting the fate of 78 percent of the subjects. With exclusion of the surgically treated patients, the discriminant analysis accurately predicted future morbidity 83 percent of the time (p < 0.0001). The following risk factors for increased morbidity were common to both analyses: severity of angina, history of myocardial infarction, family history of heart disease, fatigue and absence of type A behavior.

Adolescent↗
PubMed1980

The risk of type a mediated coronary artery disease in different populations.

Using angiographic evidence of coronary artery disease, we have examined whether certain populations were particularly susceptible for risk engendered by Type A personality. Two hundred three men were studied with the Jenkins Activity Surveys; 103 of them were also studied with the Rosenman semistructured interview. The extent of vessel disease was found unrelated to Type A in each of the three ethnic groups studied--Irish Catholic, Italian Catholic, and white Anglo-Saxon Protestant. Likewise, no relationship between Type A and vessel disease was discerned in high depressed, low depressed, high stressed, or low stressed individuals. Finally, we examined whether cardiac symptomatology could affect any relationship found between Type A personality and vessel disease. No significant relationship was discerned in patients who had experienced or had not experienced a myocardial infarction or in patients with mild, moderate, or severe exertional angina.

Adult↗
PubMed1979

Predicting results of coronary angiography.

This study compares the ability of various risk factor combinations to predict the extent of coronary artery disease found on coronary angiography. Risk factors were measured in 99 patients prior to coronary angiography. Clinical, epidemiological, psychosomatic, and combined orientations were compared as to their ability to predict angiography results. The clinical orientation was the most successful in predicting vessel disease (p less than .0001), followed by the epidemiological model, which was also successful (p less than .03). In contrast, psychosomatic factors were not accurate predictors of vessel disease. By combining all of the orientations, the accuracy of prediction is improved.

Adult↗
PubMed1978

Type A personality and extent of coronary atherosclerosis.

The relation between type A personality and the extent of coronary artery disease was studied in 109 patients who underwent selective coronary angiography. Type A personality as measured with the Jenkins Activity Survey was not correlated with the extent of coronary artery disease as assessed from the number of vessels with 50 percent or greater narrowing of diameter.

Adult↗